Which is India's native COVID-19 vaccine

By Alankrita Taneja, MBBS In early April 2021, I was pulled out of an elective rotation to cover medical ICUs due to an increase in the number of COVID-19 cases in Michigan.

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During one of those days with overnight calls, I noticed some missed phone calls from home in India. I was able to text my family frequently and was informed that my dear grandfather had developed a high-grade fever and cough.

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Cold shivers ran down my spine as I thought of the worst case scenario. He was almost 90 years old and had barely left his home in more than a year since the pandemic hit.

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There was a long silence at the beginning of this year in COVID-19 cases in India, which left epidemiologists doubting whether the country had somehow escaped the devastation of the pandemic.

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There have been theories about people in India having a possible early herd immunity despite a low vaccination rate. As a result, the country opened up, especially New Delhi, the capital and one of the most populous cities in the country — and my hometown.

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My grandfather received the first dose of Covaxin, which is India's native COVID-19 vaccine. He recently resumed his pre-pandemic morning walks at the park and was very happy to finally be able to enjoy his favorite activity again.

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Unfortunately, it was also the decision he began to regret most.

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Within the next few days, his condition worsened. My parents and uncle jumped in to help him with household chores, medical tests and medications, with full precautions including wearing PPE.

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When my grandfather was tested for COVID-19, it was found to be negative by PCR. He then underwent high-resolution CT imaging of his chest due to a high false negative rate of COVID-19 PCR in New Delhi.

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Based on a score called CORADS, he was found to have a very high suspicion for COVID-19. He also received blood tests that revealed evidence of liver and kidney injury.

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We decided to get him admitted for fluids and monitoring. Due to a negative COVID-19 PCR test, he was able to obtain an ICU bed at a non-COVID-19 designated hospital in his neighborhood. However, he was tested again while inpatient and happened to be positive this time.

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I curiously googled the number of COVID-19 cases in India and was shocked to see an almost perfect vertical straight line representing India's second wave of the pandemic.

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I was shocked because it was nothing like what I had seen all year with the pandemic. I was also shocked to see that not many people were scared about this - not the doctors I work with, not MedTwitter at the time, not even the media.

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After my grandfather's positive test result, he was asked to find a bed in a designated COVID-19 hospital. It was then that I began to watch the health care system in New Delhi begin to collapse. Days passed and we could not get him a hospital bed.

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Doctors prescribed him remdesivir and stressed that it could save his life. Unfortunately, it was out of stock in New Delhi. My cousin, who is not a medical professional, got a bottle of the 20,000 Indian rupee from the black market, which had some major grammatical errors in the appendix that made us realize it was a counterfeit version.

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I kept asking my family to take my grandfather's cell phone into his room so he would not be so alone in this critical time. Unfortunately, according to the hospital staff, his belongings were not allowed to be taken. Shortly after his admission, he was intubated and placed on a ventilator.

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I was upset that no one even took the time to inquire about his code status. In addition, since he was a COVID-positive patient on air and contact precautions in a non-COVID hospital, he was inevitably isolated and ignored by staff.

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When he was intubated, my heart sank. I had a terrible feeling in my gut that I might never be able to talk to him again.

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Within a few days, he went into cardiopulmonary arrest and was given CPR for a few minutes before being pronounced dead.

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I remember joining his last rites on Zoom that morning just before morning rounds. We usually round at 08:30, but on that particular day, our attendance at 09:00 decided for other reasons. At that moment, I wondered if it was divine intervention.

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As we mourned my grandfather's death, both my parents and my uncle and aunt - all vaccinated against COVID-19 with at least the first dose - began to develop high-grade fever.

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As suddenly as a wildfire, almost everyone I knew in New Delhi, friends and family, started getting the infection.

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The curve kept getting steeper. All are a cocktail of doxycycline, azithromycin, vitamin C, ivermectin, Fabiflu, etc. Steroids were given to all patients despite their oxygen saturation, disease severity or comorbidities.

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Brake desivir and recovery plasma were not readily available but were considered magical life-saving therapies, which led to the development of a large black market for them.

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